Population-Based Survey of Lumbar Surgery Beliefs in the United States

Purpose/Hypothesis: Studies have shown that poor lumbar surgery outcomes may be influenced by a person’s preconceived perceptions of low back surgery (LBS). However, the perceptions of the general population about issues related to lumbar surgery are not known. Therefore, the purpose of this study was to investigate the general population’s perceptions regarding LBS. Number of Subjects: This study included 262 participants (Average age: 46.1, SD=16.9; 125 Males, 137 Females) who completed the questionnaire from the general population in the Las Vegas area. Materials/Methods: Questionnaire development involved expert panel feedback from three physical therapists, three spine surgeons, two surgeon assistants/nurses, two researchers specializing in questionnaire design and two pain scientists. After revision and establishment of test-retest reliability, it was distributed at 12 grocery stores that were randomly selected from the Las Vegas area. The questionnaire consisted of demographic information, personal and family medical history, and 11 questions pertaining to perceptions of lumbar surgery. Results: Of the surveyed population, approximately one third believed that lumbar surgery is successful to the point that they would be able to return to their previous level of activity. Over half of the respondents agreed that they would be afraid to undergo back surgery. In addition, more than half believe that side effects are common and recovery from low back surgery is long. 76% of respondents agreed that they would try all other means of treatment before opting for lower back surgery, yet 39% said they would undergo back surgery if they had severe low back pain. Conclusions: Our results show that the general population has a somewhat negative bias towards back surgery with the general view that LBS will result in a poor outcome, side effects, and protracted recovery. Most of the participants are afraid to have surgery and are not confident in returning to work or participating in previous physical activities. They are also not sure whether or not lower back surgery is successful. A large majority would first attempt recovery through alternate means like physical therapy, medication, etc. Clinical Relevance: It is valuable to understand that the majority of people have a negative view on lumbar surgery. Patient education prior to surgery could be beneficial to their surgical outcomes, providing that patient expectations are approached realistically and individual variances are taken into account

Roots-eye view: using microdialysis and microCT to non-destructively map root nutrient depletion and accumulation zones

Improvement in fertiliser use efficiency is a key aspect for achieving sustainable agriculture in order to minimise costs, greenhouse gas emissions and pollution from nutrient runoff. To optimise root architecture for nutrient uptake and efficiency we need to understand what the roots encounter in their environment. Traditional methods of nutrient sampling such as salt extractions can only be done at the end of an experiment, are impractical for sampling locations precisely and give total nutrient values which can overestimate the nutrients available to the roots. In contrast, microdialysis provides a non-invasive, continuous method for sampling available nutrients in the soil. Here for the first time we have used microCT imaging to position microdialysis probes at known distances from the roots and then measured the available nitrate and ammonium. We found that nitrate accumulated close to roots while ammonium was depleted demonstrating that this combination of complementary techniques provides a unique ability to measure root-available nutrients non-destructively and in almost real-time

The physiology of adventitious roots

Adventitious roots are plant roots that form from any nonroot tissue and are produced both during normal development (crown roots on cereals and nodal roots on strawberry [Fragaria spp.]) and in response to stress conditions, such as flooding, nutrient deprivation, and wounding. They are important economically (for cuttings and food production), ecologically (environmental stress response), and for human existence (food production). To improve sustainable food production under environmentally extreme conditions, it is important to understand the adventitious root development of crops both in normal and stressed conditions. Therefore, understanding the regulation and physiology of adventitious root formation is critical for breeding programs. Recent work shows that different adventitious root types are regulated differently, and here, we propose clear definitions of these classes. We use three case studies to summarize the physiology of adventitious root development in response to flooding (case study 1), nutrient deficiency (case study 2), and wounding (case study 3)

Salt bridges regulate both dimer formation and monomeric flexibility in HdeB and may have a role in periplasmic chaperone function

Peer reviewedPublisher PD